2023 Volume 38 Issue 6 Pages 412-419
A 38-year-old man was admitted to our hospital presenting with an emergency case of severe alcoholic acute pancreatitis with complaints of abdominal pain and vomiting after alcohol intake. He underwent consecutive successful treatments for acute pancreatitis, but one month after admission a CT scan showed an abscess around the pancreatic tail extending to the retroperitoneum. A transgastric stent was placed into the abscess, followed-up by a transgastric endoscopic necrosectomy. Because the abscess cavity was large and frequent endoscopic necrosectomies were not effective, we performed a laparoscopic necrosectomy and drain placement using a retroperitoneal approach by inserting a laparoscopic port directly into the abscess cavity under CT guidance in the hybrid operating room. The abscess cavity shrank, and the patient was discharged on the 78th day post-surgery with a drain in place. Since laparoscopic necrosectomy is useful in the treatment of massive walled-off necrosis caused by severe acute pancreatitis, we report the results of this procedure with some innovations implemented in our department.
